The NHS National Programme for IT may fail to deliver what's required

A nine-month investigation of the NHS’s IT programme by an all-party committee of MPs has found that the £12.4bn scheme, the UK’s largest IT investment, may fail to deliver what is required by the health service.

The Public Accounts Committee says in a report published today [17 April 2007] that the programme has lost three key suppliers, is running late and is having difficulties meeting its objectives – which it says “raises doubts over whether the contracts will deliver what is required”.

The committee’s uncompromising report was drafted for it initially by the public spending watchdog the National Audit Office.

The Department of Health submitted copious material to public accounts MPs to show what has been achieved so far. But the Labour-dominated committee concluded that at the present rate of progress “it is unlikely that significant clinical benefits will be delivered by the end of the [10-year] contract period”.

The findings of the report undermine the main justification of the world’s largest civilian IT programme – the main aim of the National Programme for IT [NPfIT] is to improve significantly the care and treatment of patients.

The report is the culmination of several years of campaigning by Computer Weekly to highlight the programme’s risks and challenges amid a background of secrecy and little public acknowledgement in Whitehall of the scheme’s difficulties.

In response to the statistics produced by the Department such as the number of transactions being processed through national systems and the hundreds of thousands of people who have been registered to use them, the committee found that these figures represented “only a small part of the scheme”.

On the deployments so far of iSoft – the main software due to be installed in three of the five “cluster” areas in England – the committee said that this was an “old” patient administration system which pre-dates the NPfIT.

In the main text of the report, the committee has little good to say of work on the programme.

It says that:

– Although more than £2bn has been spent, suppliers are “clearly struggling to deliver”.

– Four years after the start of the Programme, there is still much uncertainty about the costs of the Programme for the local NHS and the value of the benefits it should achieve.

– Although patient administration systems are being deployed to help trusts that urgently need new systems, this technology is “not a substitute for the vision of a shared electronic patient clinical record and no firm plans have been published for deploying software to achieve this vision”.

– The Department has failed to carry an important body of clinical opinion with it

– The use of two main software suppliers may have inhibited innovation, progress and competition

Questions by Richard Bacon. who is a Conservative MP on the committee, established that consultants on the programme were earning up to £2,400 a day. At the end of July 2006 there were 471 consultants/contractors engaged with NHS Connecting for Health, an agency that is running the NPfIT.

Bacon said it was difficult to avoid the conclusion from the findings that the NPfIT has been a failure so far. He wants trusts to be able to buy their main systems from a range of suppliers whose technology conforms to national standards.

Thomas Brooks, a member of the Worshipful Company of Information Technologists and the all-party Parliamentary IT committee, is quoted in the report as saying there was no evidence that Local Service Providers – companies that have been awarded £6.2bn worth of contracts – have added “any value to the national programme”.

The Department told the committee that, as the programme had proceeded, clinicians and other users had been involved in much more detail, and that 470 clinicians had, for example, been recently involved in looking at the requirement to support electronic prescribing. But the committee concluded that the specification of the solution and the terms of the contract had already been set before the consultation began.

Lord Hunt, minister in charge of the NPfIT, gave his response to the committee’s report – here.